LX SAMPLE FORM ONLY Project ID:
Transcription
LX SAMPLE FORM ONLY Project ID:
SAMPLE FORM ONLY AUSTRALIAN RESEARCH COUNCIL LINKAGE INTERNATIONAL APPLICATION FORM FOR PROPOSALS FOR FUNDING COMMENCING IN 2008 Awards LX Note: you must read the ‘Linkage International Funding Rules for Proposals for funding commencing in 2008’ and the relevant ‘Linkage International Instructions to Applicants for Proposals for funding commencing in 2008’ before filling out this form. Project ID: Total number of sheets contained in this application Information on this form and its attachments is collected in order to make recommendations to the Minister on the allocation of financial assistance under the Australian Research Council Act 2001 and for post award reporting. The information collected may be passed to third parties for assessment purposes. It may also be passed to the National Health and Medical Research Council, the Department of Foreign Affairs and Trade, the Department of Industry, Tourism and Resources, the Department of the Environment and Heritage, the Department of Education, Science and Training, the Department of Agriculture, Fisheries and Forestry and the Department of Veterans’ Affairs for the purpose of checking eligibility. In other instances, information in this Proposal can be disclosed without your consent where authorised or required by law. PART A—ADMINISTRATIVE SUMMARY A1 ORGANISATION TO ADMINISTER FUNDING (Please note this question must be completed first) Name A2 PROPOSAL TITLE (Provide a short descriptive title of no more than 20 words. Avoid the use of acronyms, quotation marks and upper case characters.) A3 PARTICIPANT SUMMARY A3.1 Participant Details - Current Organisations (Enter details of the lead Chief Investigator at Person number 1) Chief Investigator (CI), Overseas Investigator (OI), and Partner Investigator (PI) Person Family name Initials Current Organisation number 1 2 3 4 5 Role A3.2 Participant Summary - Organisations applicable to this Proposal (This table is ‘read only’ and provides a Summary of Organisational Affiliations for participants. This table will populate once B8.2 is completed for each participant.) Person Number 1 2 3 Family Name Initials Current Organisation Relevant Organisation for this Proposal SAMPLE FORM ONLY Role SAMPLE FORM ONLY A4 REQUESTED SUPPORT A4.1 This Proposal requests funding for the following scheme category: Linkage International Awards A4.2 Years for which support is being sought from the ARC Year 1 Year 2 Year 3 A4.3 ARC Projects funded for 2007 that include this Proposal's first-named CI (This question is mandatory - please refer to Linkage International Funding Rules subsection 12.1.3.2) Scheme A5 Project ID st Project's 1 named CI Project Title Approved years of funding (incl. 2007) SUMMARY DESCRIPTIONS A5.1 Summary of Proposal In no more than 100 words (approx. 750 characters) of plain language, summarise aims, significance and expected outcomes of the collaborative research. A5.2 Summary of Collaboration In no more than 100 words (approx. 750 characters) of plain language, summarise the proposed collaboration. A5.3 Summary of National/Community Benefit (for Public Release) In no more than 100 words (approx. 750 characters) of plain language, summarise the national/community benefits that are expected to arise from the collaborative research. A6 CLASSIFICATIONS AND OTHER STATISTICAL INFORMATION A6.1 National Research Priorities. If relevant, click the ‘National Research Priorities’ button to select one or more relevant Priority Goals for a designated National Research Priority. National Research Priority Priority Goal(s) SAMPLE FORM ONLY SAMPLE FORM ONLY A6.2 Keywords A6.3 Research classifications (list from highest to lowest %, to the nearest multiple of 10%) Research Fields, Courses and Disciplines (RFCD) % Socio-Economic Objective (SEO) % A6.4 Country/ies of international collaboration A7 ADDITIONAL DETAILS A7.1 Have you submitted or do you intend to submit a similar Proposal to any other agency? Yes No If yes, please select one of the following: If other is selected above, please enter the full name of the agency: A7.2 Has a successful eligibility exemption/ruling been granted by the ARC relating to this Proposal? Yes No a) If Yes, please indicate the type of eligibility exemption/ruling granted and enter the 10-digit identifying number for the exemption/ruling provided by the ARC: Eligibility Ruling type: Successful exemption number(s) (Eg. LXEC08----): Medical and Dental Research Overseas Organisation Other If Other, please specify the type(s) of eligibility ruling granted: SAMPLE FORM ONLY SAMPLE FORM ONLY A7.3 Does the Administering Organisation have arrangements to manage intellectual property and facilitate commercialisation of research? Yes No If Yes, in no more than 100 words (750 characters) of plain language, summarise these arrangements. A8 RESEARCH STUDENTS The ARC is interested in reporting the number of Research Students that would be involved in this Proposal if it is funded. Please enter the number of students places (full-time equivalent) that will be filled as a result of this project. (Round FTE to 1 decimal place) Australia Overseas PhD Masters Honours SAMPLE FORM ONLY SAMPLE FORM ONLY A9 CERTIFICATION The Administering Organisation must obtain the required agreement and hand-written signature(s) of all parties necessary to allow the proposed research to proceed. Certification by the Deputy/Pro Vice-Chancellor (Research) or their delegate or equivalent in the Administering Organisation I certify that— • I have obtained the written agreement of all parties identified in the Proposal to submit this Proposal. • Proper enquiries have been made and I am satisfied that the participants listed in Part A3 meet the requirements specified in the ‘Linkage International Funding Rules for funding commencing in 2008’. • The Head of Department has approved this Proposal. • This organisation supports this Proposal and if successful will provide basic facilities and the items listed in the budget for the project. • I have obtained the written agreement of the other organisation(s), if any, involved in this Proposal to contribute the resources outlined in this Proposal. • I have obtained the written agreement from the relevant employer(s) for the participation, to the extent indicated in this Proposal, of the participants listed in Part A3. • I am prepared to have the project carried out in my organisation under the circumstances set out in this Proposal and in accordance with the ‘Linkage International Funding Rules for funding commencing in 2008’. • The amount of time that the researcher(s) will be devoting to the project is appropriate to existing workloads. • The project can be accommodated within the general facilities in this organisation, and if applicable, within the facilities of other relevant organisations specified in this Proposal, and sufficient working and office space is available for any proposed additional staff. • All funds for this project will only be spent for the purpose for which they are provided. • The project will not be permitted to proceed until appropriate ethical clearance(s) has been obtained. • I will notify the ARC if there are changes to named participant(s) listed in Part A3 after the submission of this Proposal. • To the best of my knowledge, all conflicts of interest relating to parties involved in or associated with this proposal which arise after the submission of this Proposal. • I consent, on behalf of all the parties, to the ARC copying, modifying and otherwise dealing with information contained in this Proposal for any of the purposes specified in subsection 11.4.2 of the ‘Linkage International Funding Rules for funding commencing in 2008’. • I consent, on behalf of all the parties, to this Proposal being referred to third parties, who will remain anonymous, for assessment purposes. • To the best of my knowledge, the Privacy Notice appearing at the top of this application form has been drawn to the attention of all the participant(s) whose personal details have been provided at Part B. • To the best of my knowledge all details provided in this application form and in any supporting documentation are true and complete and no information specifically relating to personnel track or publication records is false or misleading. • I understand that it is an offence under the Criminal Code Act 1995 to provide false or misleading information. • I understand and agree that all statutory requirements must be met before the proposed research can commence. Signature of DVC/PVC(R), delegate or equivalent (in black ink) Name and Position (please print) SAMPLE FORM ONLY Date SAMPLE FORM ONLY PART B—PERSONNEL B1 PERSON NUMBER B2 CURRENT DETAILS GAMS ID Family name Role First name Second name Title Current Department/school/other Current Organisation B3 POSTAL ADDRESS Department/school/other Organisation Postal address line 1 Postal address line 2 Locality B4 State Postcode Country MEMBERSHIPS/ASSOCIATIONS B4.1 Are you a current member of the ARC or its advisory committees? Yes No B4.2 Are any of your relatives or close social/professional associates members of the ARC or its advisory committees? Yes No If Yes, please name the ARC member(s) B5 HAVE YOU EVER BEEN AWARDED A FELLOWSHIP FROM THE ARC? Yes No Please indicate if you have received any of the following Fellowships from the ARC: APD, APDC, APDI, ARF, QEII, SRF, APF, RC-ATSI, IRF or ARCIF. Project ID Year funding Year funding Fellowship type(s) commenced concluded (or expected to conclude) B6 AFFILIATIONS If you are nominated as a Chief Investigator, will you be receiving salary in 2008 from an organisation which is outside the higher education sector and which is funded predominantly from State/Territory or Commonwealth Government sources and such funding is provided mainly for research activities? Yes No If yes, describe the nature of your employment, association, and/or financial interest (including specifying the % of salary): SAMPLE FORM ONLY SAMPLE FORM ONLY B7 QUALIFICATIONS B7.1 PhD qualification awarded Discipline/Field Organisation Country Month and Year awarded (mm/yyyy) (or) Date Thesis Submitted/ Proposed Submission Date B7.2 Other qualifications (including highest Qualification if not PhD) Degree/Award B8 Year Discipline/Field Organisation and Country ACADEMIC, RESEARCH, PROFESSIONAL AND INDUSTRIAL EXPERIENCE B8.1 Current and previous appointment(s)/position(s) - during the past 10 years Position held B8.2 Organisation Department Duration and Status Organisational affiliations for eligibility purposes of this Proposal Name of the organisation you will be associated with for the purposes of satisfying the eligibility requirements for your nominated role in undertaking the proposed research collaboration (see Sections 5 and 12 of the ‘Linkage International Funding Rules for funding commencing in 2008’) Role CI, OI, PI Organisation Type of Affiliation [Select Organisation for CIs. For OIs or PIs select relevant organisation or ‘Other’ and type the name of the relevant organisation] [Select from Employee, Adjunct Appointment, Federation Fellow, Other] SAMPLE FORM ONLY SAMPLE FORM ONLY This page serves as a check list for PART B9 Once the Application Form has been printed, replace this page with the following pages: B9 CURRICULUM VITAE Attach to the Application Form a curriculum vitae of one page for each named participant at A3, including the following details: • name • a list of the ten most significant relevant publications for the last five years • the total number of peer-reviewed research publications over the last five years • any other relevant details not included elsewhere within the Application Form SAMPLE FORM ONLY SAMPLE FORM ONLY PART C—PROJECT COST Costs should be quoted exclusive of the GST. C1 BUDGET DETAILS C1.1 Year COSTING Column 1 Source of funds 2 ARC 3 Administering Organisation COSTS Travel - Airfares Total Airfares (a) Travel - Other (Local & Subsistence) Total Other Travel (b) Consumables (up to $5,000) Total Consumables (c) Other Total Other (d) TOTAL COSTS (e) SAMPLE FORM ONLY 4 Other 5 Total SAMPLE FORM ONLY This page serves as a check list for PART C2, C3 and C4 Once the Application Form has been printed, replace this page with the following pages: C2 JUSTIFICATION OF FUNDING REQUESTED FROM THE ARC In no more than one A4 page fully justify in terms of need and cost, each budget item requested from the ARC (Column 2 in Section C1), including value for money. Use the same headings as in Column 1 of Section C1. C3 DETAILS OF NON-ARC CONTRIBUTIONS In no more than one A4 page provide on explanation of how non-ARC contributions (Columns 3 and 4 in Section C1) will support the Proposal (use the same headings as in Column 1 of Section C1). Contributions from Partner Investigators must be highlighted. C4 LETTERS OF SUPPORT A letter of support must be attached from any Organisation other than the Administering Organisation indicating financial commitment to the proposed collaborative research project. SAMPLE FORM ONLY SAMPLE FORM ONLY PART D—RESEARCH SUPPORT D1 RESEARCH SUPPORT OF ALL PARTICIPANTS For each participant listed in Part A3, provide details of research funding for the years specified in the table below. That is, list all projects/proposals/fellowships awarded and any requests submitted involving that participant for funding. • The current Proposal is listed first and will be auto populated into the table. List other Proposals and/or projects (including fellowships) in descending date order. • ARC-funded projects/fellowships for which reports (including Progress and Final Reports) required in the Conditions of Grant/Funding Contract/Funding Agreement have been submitted should be indicated by a double asterisk (**) after the Description. • Asterisk (*) refers to any items that are in the same area of research as this Proposal. • Support types (Sup type) are ‘R’ for requested support, ‘C’ for current support, ‘P’ for past support. • The ARC Project ID applies only to Proposals, current and past projects (including fellowships), funded by the ARC. Note, details should be provided for all sources of funding, not just ARC funding. Show all amounts in Australian dollars. Description (All named investigators on any Proposal or grant on which a participant is involved, project title, source of support, scheme) (*) Sup type ARC Project ID 2006 ($’000) 2007 ($’000) 2008 ($’000) (if applicable) Current proposal begins in 2008 SAMPLE FORM ONLY 2009 ($’000) 2010 ($’000) SAMPLE FORM ONLY This page serves as a check list for PART D2 Once the Application Form has been printed, replace this page with the following page(s) (where appropriate): D2 STATEMENTS ON PROGRESS OF ARC-FUNDED PROJECTS For each participant listed Part A3, include with the Proposal a statement detailing progress for each project/fellowship involving that participant which has been awarded funding for 2006 under any ARC scheme. D2.1 List of the projects that you are providing statements for: E.g. Scheme Project ID First named investigator Project Title D2.2 Provide the statements Write no more than one A4 page for each funded project. SAMPLE FORM ONLY SAMPLE FORM ONLY This page serves as a check list for PART E Once the Application Form has been printed, replace this page with the following: PART E - PROPOSAL DESCRIPTION E1 ADDITIONAL TEXT Additional text must be provided addressing the selection criteria at the relevant Section of the 'Linkage International Funding Rules for funding commencing in 2008' within the format specified in the Funding Rules. Linkage International Awards In no more than three A4 pages, consider the selection criteria and provide the following information: E1.1 a brief outline of the aims, significance, background and expected results for the proposed collaborative research project; E1.2 a brief description of the nature, strengths and benefits of the collaboration including the role of, and benefit to, the Australia-based and overseas parties; and E1.3 a management plan for the collaboration, including a proposed schedule of visits. Please present this plan as a table with the following information for each visit: dates, name and status of researcher(s) travelling, destination, activity to be performed and funding source. SAMPLE FORM ONLY